Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Hosting capacity of the power grid for electric vehicles - A case study on a Swedish low voltage grid

Hosting capacity (HC) is described as the maximum amount of new production or consumption that can be added to the grid without causing a violation. In this case study, a deterministic approach is used to investigate the HC of electric vehicle (EV) charging in a low-voltage grid, containing 13 detached single-family houses. It investigates how different parameters affect the HC, and what is causing the violation in the grid. Two different performance indices (PI) are used in the study: power cable overloading and voltage drop. The local grid is simulated for one year for four cases and the HC is derived for these. The cases are distinguished by two different violation thresholds for the voltage drop and two different implementation orders of the location of the charging. The results show that the HC of the grid is 6-11 EVs charging simultaneously. The difference in HC is primarily due to variation in the baseload through the year and location of charging. The cable between the substation and the first cable cabinet was the major contributor to the fault, and the PI causing the violation differed depending on what case was used

The Uber Million Dollar Question: Are Uber Drivers Employees or Independent Contractors?

It was a snowy evening in Paris when 2008 LeWeb Technology Conference attendees Travis Kalanick and Garrett Camp were trying to catch a taxicab. Frustrated with being stuck in the cold without a ride, the two eventually found a way back to their apartment on the outskirts of the city and started talking with a few other entrepreneurs about potential start-ups. Not surprisingly, an idea they discussed that night was a smartphone application, or app, that could pick up passengers the moment they requested a ride. Although neither Kalanick nor Camp probably knew it at the time, this simple idea would lead to the creation of Uber, one of the most popular ridesharing apps of the twenty-first century. ... This Article considers whether Uber drivers are employees or independent contractors. First, this Article discusses the Uber app itself, its place in the sharing economy, and the current tests that distinguish employees from independent contractors. Next, it analyzes both Uber\u27s arguments that its drivers are independent contractors, as well as the drivers\u27 arguments that they are employees. After applying today\u27s tests to Uber\u27s business model, this Article argues that the laws do not provide a clear answer as to whether the drivers should be classified as employees or independent contractors. Ultimately, it recommends that the tests be applied on a case-by-case basis to consider the different types of individuals participating in the sharing economy, and that the tests be reconsidered in light of the tension between control and user safety that exists today

Solar district heating and cooling: A review

Both district heating and solar collector systems have been known and imple- mented for many years. However, the combination of the two, with solar collec- tors supplying heat to the district heating network, is relatively new, and no comprehensive review of scientific publications on this topic could be found. Thus, this paper summarizes the literature available on solar district heating and presents the state of the art and real experiences in this field. Given the lack of a generally accepted convention on the classification of solar district heating systems, this paper distinguishes centralized and decentralized solar district heating as well as block heating. For the different technologies, the paper describes commonly adopted control strategies, system configurations, types of installation, and integration. Real‐world examples are also given to provide a more detailed insight into how solar thermal technology can be integrated with district heating. Solar thermal technology combined with thermally driven chillers to provide cooling for cooling networks is also included in this paper. In order for a technology to spread successfully, not only technical but also eco- nomic issues need to be tackled. Hence, the paper identifies and describes dif- ferentSHINE - SolNe

Seven Phd Studies on Solar District Heat

The Solar Heat Integration NEtwork (SHINE) is a European research school in which 13 PhD students insolar thermal technologies are funded by the EU Marie-Curie program. It has five PhD course modules aswell as workshops and seminars dedicated to PhD students both within the project as well as outside of it.The SHINE research activities focus on large solar heating systems and new applications: on district heating,industrial processes and new storage systems. The scope of this paper is on systems for district heating forwhich there are six PhD students, three at universities and two at companies. In addition there is a seventhPhD in a Swedish national research school focused on energy efficiency within district heating networks(Reesbe). The initial work has concentrated on literature studies and on setting up initial models andmeasurement setups to be used for validation purposes. Some results of these studies are presented in thepaper. The PhD students will complete their studies in 2017-18

Cortical M1 receptor concentration increases without a concomitant change in function in Alzheimer\u27s disease

Although the M1 muscarinic receptor is a potential therapeutic target for Alzheimer\u27s disease (AD) based on its wide spread distribution in brain and its association with learning and memory processes, whether its receptor response is altered during the onset of AD remains unclear. A novel [35S]GTPγS binding/immunocapture assay was employed to evaluated changes in M1 receptor function in cortical tissue samples harvested from people who had no cognitive impairment (NCI), mild cognitive impairment (MCI), or AD. M1 function was stable across clinical groups. However, [3H]-oxotremorine-M radioligand binding studies revealed that the concentration of M1 cortical receptors increased significantly between the NCI and AD groups. Although M1 receptor function did not correlate with cognitive function based upon mini-mental status examination (MMSE) or global cognitive score (GCS), functional activity was negatively correlated with the severity of neuropathology determined by Braak staging and NIA-Reagan criteria for AD. Since M1 agonists have the potential to modify the pathologic hallmarks of AD, as well as deficits in cognitive function in animal models of this disease, the present findings provide additional support for targeting the M1 receptor as a potential therapeutic for AD. © 2010 Elsevier B.V